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Prevalence of circumcision
The prevalence of circumcision (or circumcision rate) refers to the proportion of males that are circumcised in a given population. It may also refer to the proportion of newborn males that are circumcised. The World Health Organisation estimates that as of 2006, 30% to 34% of males aged 15 or older (or approximately 665 million men or boys) are circumcised worldwide.Male circumcision - global trends and determinants of prevalence, safety and acceptability by World Health Organization, UNAIDS, UNICEF, UNFPA ,ANRS and World Bank Estimates of the proportion of all males that are circumcised worldwide include one sixth,Williams N, Kapila L. Complications of circumcision. Brit J Surg. 1993;80:1231-6. (full text) one third,Crawford DA. Circumcision: a consideration of some of the controversy. J Child Health Care. 2002 December;6(4):259-70. PMID 12503896 and between 30 and 40%. Canada, the United Kingdom and Australia have seen a decline in male circumcision, while there are indications of increasing demand in Southern Africa. The following list states the proportion of males circumcised by country. Africa Studies indicate that about 62% of African males are circumcised overall. However, these rates differ by region, ethnic and religious groups. Williams, B.G. et al. comment that "Most of the currently available data on the prevalence of circumcision are several decades old, while several of the recent studies were carried out as adjuncts to demographic and health surveys and were not designed to determine the prevalence of circumcision." Less than 20% Rwanda, Burundi, Zambia, Zimbabwe, Malawi, Botswana, Namibia, Swaziland, Canary,Is. (Spain). Between 20 and 80% Côte d'Ivoire (Ivory Coast), Central African Republic, Sudan, Uganda, Tanzania, Mozambique, South Africa, Lesotho. 80% or more Algeria, Morocco, Mauritania, Tunisia, Libya, Egypt, Mali, Senegal, Gambia, Guinea-Bissau, Guinea, Liberia, Sierra Leone, Ghana, Togo, Benin, Burkina Faso, Niger, Nigeria, Chad, Cameroon, Equatorial Guinea, Gabon, Republic of the Congo, Democratic Republic of the Congo, Eritrea, Ethiopia, Djibouti, Somalia, Kenya, Angola, Mauritius, Madagascar. Americas Less than 20% Mexico, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Cuba, Jamaica, Haiti, Dominican Republic, Puerto Rico, Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, French Guiana, Guyana, Paraguay, Peru,Trinidad and Tobago, Venezuela. The overall prevalence of circumcision is reported to be 6.9% in Colombia, and 7.4% in Brazil. The prevalence of circumcision in Mexico is estimated to be 10% to 31%. Between 20 and 80% Canada, United States. United States Statistics from different sources give widely varying estimates of infant circumcision rates in the United States. Data from a national survey conducted from 1999 to 2002 found that the overall prevalence of male circumcision in the United States was 79%. 91% of men born in the 1970s, and 83% of boys born in the 1980s were circumcised. An earlier survey, conducted in 1992, found a circumcision prevalence of 77% in US-born men, born from 1932-1974, including 81% of non-Hispanic White men, 65% of Black men, and 54% of Hispanic men, vs. 42% of non U.S. born men who were circumcised. A recent study, which used data from the Nationwide Inpatient Sample (a sample of 5-7 million of the nation's total inpatient stays, and representing a 20% sample taken from 8 states in 1988 and 28 in 2000), stated that neonatal circumcisions rose from 48.3% of males in 1988 to 61.1% in 1997. PMID 15711354 | url = http://www.jurology.com/article/PIIS0022534705604193/abstract | format = Abstract | doi = 10.1097/01.ju.0000145758.80937.7d | accessdate = 2006-09-21 }} Figures from the 2003 Nationwide Hospital Discharge Survey state that circumcision rates declined from 64.7% in 1980 to 59.0% in 1990, rose to 64.1% in 1995, and fell again to 55.9% in 2003. On page 52, it is shown that the western region of the United States has seen the most significant change, declining from 61.8% in 1980 to 31.4% in 2003. Part of the decline in the western region has been attributed by some experts to an increasing percentage of births to immigrants from Latin America, who have been shown to be less likely to circumcise than other parents in the U.S. There are various explanations for why the infant circumcision rate in the United States are different from comparable countries. Many parents’ decisions about circumcision are preconceived, and this may contribute to the high rate of elective circumcision. Medicaid funding for infant circumcision used to be universal in the United States; however, sixteen states no longer pay for the procedure under Medicaid. One study in the Midwest of the U.S. found that this had no effect on the newborn circumcision rate but it did affect the demand for circumcision at a later time. PMID 14501653 | accessdate = 2006-09-21 | doi = 10.1097/01.ju.0000091215.99513.0f }} Schoen states that the "80% to 85% US circumcision rate observed in practice contrasts with the 55% to 65% rate reported in statistics collected from birth centers across the nation". The explanation he offers is that "the published results of national statistical surveys represent only coded diagnoses obtained from birth centers; the reported figures do not include males who are circumcised at a later date for religious, medical, or personal reasons or who received newborn circumcision that was not coded." PMID 16818586 | url = http://pediatrics.aappublications.org/cgi/content/extract/118/1/385 | accessdate = 2006-09-21 | doi = 10.1542/peds.2005-2881 }} Canada The Canadian Paediatric Society cites an estimate of 48% for the prevalence of male circumcision in Canada in 1970. Statistics compiled by Wirth for the period 1970-1980 show large variations between provinces and "a fairly rapid decrease in the rate, except in the Yukon and Saskatchewan". (see table) In 1994/95, the newborn circumcision rate in Ontario was 299.1 per thousand or 29.9%. In 1999, the American Academy of Pediatrics reported that “in Canada, ~48% of males are circumcised”. However, this figure has been questioned because the only citation provided for it is an Australian paper dating from 1970. Articles published in 2003 report Canadian neonatal male circumcision rates of "10 to 30%" and "less than 17%". According to the Halifax Daily News, the infant circumcision rate in 2003 was "just 1.1 per cent" in Nova Scotia and nil in Newfoundland. Asia Less than 20% Russia, Mongolia, China, Taiwan, North Korea, India, Sri Lanka, Nepal, Bhutan, Burma, Thailand, Laos, Vietnam, Cambodia, Japan, Papua New Guinea. The overall prevalence of circumcision in Thailand is reportedly 13.3%. Between 20 and 80% Kazakstan. 80% or more Israel, South Korea, Bangladesh, Pakistan, Afghanistan, Azerbaijan, Bahrain, Brunei, Tajikistan, Kyrgyzstan, Uzbekistan, Turkmenistan, Iran, Iraq, Kuwait, Turkey, Syria, Lebanon, Jordan, Saudi Arabia, Yemen, Oman, United Arab Emirates, Qatar, Malaysia, Philippines. The overall prevalence of circumcision in the Philippines is reported to be 92.5%. Most circumcision in the Philippines are performed at the age of 11 to 13. According to Dr. Inon Schenker of the Jerusalem AIDS Project, "about 100 percent of men have been circumcised" in Israel. According to the World Health Organisation, 80% or more of males in South Korea are circumcised. A 2001 study of 20-year old South Korean men found that 78% were circumcised. The authors comment "South Korea has possibly the largest absolute number of teenage or adult circumcisions anywhere in the world. Because circumcision started through contact with the American military during the Korean War, South Korea has an unusual history of circumcision." Europe Less than 20% The following countries have a circumcision rate of less than 20%: Iceland, United Kingdom, Ireland, Sweden, Norway, Finland, Denmark, Estonia, Latvia, Lithuania, Portugal, Spain, France, Switzerland, Italy, Netherlands, Belgium, Slovakia, Germany, Poland, Czech Republic, Hungary, Greece, Bulgaria, Romania, Moldova, Ukraine, Austria, Belarus, Russia, Cyprus, Georgia. A national survey on sexual attitudes in 2000 found that 15.8% of men or boys in the United Kingdom (ages 16–44) were circumcised. 11.7% of 16-19 year olds, and 19.6% of 40-44 year olds said they had been circumcised. It also found that, apart from black Caribbeans, men born overseas were more likely to be circumcised. Rickwood et al reported that the proportion of English boys circumcised for medical reasons had fallen from 35% in the early 1930s to 6.5% by the mid-1980s. An estimated 3.8% of male children in the UK in 2000 were being circumcised by the age of 15. The researchers stated that too many boys, especially under the age of 5, were still being circumcised because of a misdiagnosis of phimosis. They called for a target to reduce the percentage to 2%. Denniston reported in 1996 that the neonatal circumcision rate in Finland is zero and that the rate of later circumcision is 1 in 16,667. Similarly, Wallerstein estimated in 1980 that the Finnish rate of adult circumcision for health reasons is six per 100,000.Wallerstein, E., Circumcision: an American Health Fallacy, New York, Springer, 1980. Schoen et al., however, reported in 2006 that data from 1996-1998 indicate a circumcision rate of about 7.1%; Houle reported the same figure in 2007. Finland's Ministry of Social Affairs and Health reported in 2004 that, "some 500-1000 circumcisions are performed as a therapeutic measure annually in Finnish hospitals", amounting to 710 nationwide cases in 2002.Ibid., p. 39. The overall prevalence of circumcision in Spain is reported to be 1.8%. In 1986, only 511 out of approximately 478,000 Danish boys aged 0–14 years were circumcised. This corresponds to a cumulative national circumcision rate of around 1.6% by the age of 15 years. Between 20 and 80% Slovenia, Bosnia, Serbia, Montenegro, Albania, Macedonia. Not known Luxemburg, Croatia, Andorra Map unclear Monaco, San Marino, Vatican City, Liechtenstein, Malta Oceania Less than 20% According to the World Health Organisation, fewer than 20% of males are circumcised in New Zealand. In a study of men born in 1972-1973 in Dunedin, 40.2% were circumcised. In a study of men born in 1977 in Christchurch, 26.1% were circumcised. A 1991 survey conducted in Waikato found that 7% of male infants were circumcised. Between 20 and 80% Australia. A survey of Australian men, conducted in 2001-2002, reported that 58.7% were circumcised. According to the Sydney Morning Herald, the infant circumcision rate in Australia was 12.9% as of 2003. However, rates in the states varied, with highest rates in Queensland (19.3%), New South Wales (16.3%) and South Australia (14.3%), and the lowest in Tasmania (1.6%). Non-therapeutic infant circumcision is no longer provided in public hospitals in New South Wales, Tasmania, and Western Australia, with a similar ban taking effect in Victoria in September 2007. South Australia followed suit two months later. Pacific Island 100% Guam, Northern Mariana Islands, and Niue. References External links *Drain PK, Halperin DT, Hughes JP, Klausner JD, Bailey RC. Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. BMC Infect Dis 2006 Nov 30;6:172 Category:Circumcision